Web-based tailored intervention programs show considerable promise in effecting health-promoting behaviors and improving health outcomes across a variety of medical conditions and patient populations. This meta-analysis compares the effects of tailored versus nontailored web-based interventions on health behaviors and explores the influence of key moderators on treatment outcomes. Forty experimental and quasi-experimental studies (N =20,180) met criteria for inclusion and were analyzed using meta-analytic procedures. The findings indicated that web-based tailored interventions effected significantly greater improvement in health outcomes as compared with control conditions both at posttesting, d =.139 (95% CI = .111, .166, p <.001, k =40) and at follow-up, d =.158 (95% CI = .124, .192, p <.001, k =21). The authors found no evidence of publication bias. These results provided further support for the differential benefits of tailored web-based interventions over nontailored approaches. Analysis of participant/descriptive, intervention, and methodological moderators shed some light on factors that may be important to the success of tailored interventions. Implications of these findings and directions for future research are discussed.

Studies have reported conflicting results on the association between body mass index (BMI) and prognosis of colorectal cancer. Therefore, we have conducted a meta-analysis of prospective studies, which examined the association of pre- and post-diagnostic BMI with colorectal cancer-specific mortality and all-cause mortality in patients with colorectal cancer. We searched Medline and EMBASE database published between 1970 and September 2014. A total of 508 articles were identified, of which 16 prospective cohort studies were included for the current meta-analysis. The analysis included 58,917 patients who were followed up over a period ranging from 4.9 to 20 years (median: 9.9 years). We found that being underweight before cancer diagnosis was associated with increased all-cause mortality (Relative risk [RR]: 1.63, 95% CI: 1.18–2.23, p < 0.01) and being obese (BMI ≥ 30 kg/m2) before cancer diagnosis was associated with increased colorectal cancer-specific mortality (RR: 1.22, 95% CI: 1.003–1.35, p < 0.01) and all-cause mortality (RR: 1.25, 95% CI: 1.14–1.36, p < 0.01). On the other hand, being underweight (RR: 1.33, 95% CI: 1.20–1.47, p < 0.01), obese (RR: 1.08, 95% CI: 1.03–1.3, p < 0.01), and class II/III obese (BMI ≥ 35 kg/m2; RR: 1.13, 95% CI: 1.04–1.23, p < 0.01) after diagnosis were associated with significantly increased all-cause mortality. Being obese prior to diagnosis of colorectal cancer was associated with increased colorectal cancer-specific mortality and all-cause mortality, whereas being obese after diagnosis was associated with increased all-cause mortality. The associations with being underweight may reflect reverse causation. Maintaining a healthy body weight should be discussed with colorectal cancer survivors.

Purpose The purpose of this study was to examine the effect of an oncologists’ exercise recommendation with and without exercise motivation package on the amount of exercise participation and quality of life (QOL) in breast and colon cancer survivors. Methods A total of 162 early stage breast and colorectal cancer survivors who completed primary and adjuvant treatments were recruited for this study. Participants were randomly assigned into one of three groups: 1) control (N=59), 2) Oncologists’ exercise recommendation (N=53), and 3) Oncologists’ exercise recommendation with exercise motivation package (N=50). At baseline and after 4 weeks, the level of exercise participation and QOL were assessed. Results A total of 130 (80.7%) participants completed the 4-week assessment. The result showed that participants who only received oncologists’ exercise recommendation did not increase their exercise participation level. But participants who received oncologist’s exercise recommendation with motivation package significantly increased the level of exercise participation [4.30±7.84 Metabolic Equivalent of Task (MET) hour per week, p<001] compared with that of the control group and significantly improved role functioning, pain and diarrhea. Conclusion Oncologists’ exercise recommendation may not be enough to increase exercise participation.. Exercise motivation package with oncologists’ exercise recommendation may be ideal to increase exercise participation to cancer survivor Implications of cancer survivors The providence of exercise motivation package in addition to oncologists’ exercise recommendation to increase the level of exercise among breast and colorectal cancer survivors should be considered.

Insulin, IGF axis, adiponectin, and inflammatory markers are associated with breast cancer. Given that physical activity improves prognosis of breast cancer survivors, we investigated the effects of exercise on these markers as potential mediators between physical activity and breast cancer. PubMed, EMBASE, CENTRAL, CINAHL, and SportDiscus were searched up to December 3, 2015, to identify randomized controlled trials (RCT) that investigated the effect of exercise on insulin, IGF axis, and cytokines in breast cancer survivors. Weighted mean difference (WMD) was calculated using either fixed- or random-effects models on the basis of the heterogeneity of the studies. A total of 18 studies involving 681 breast cancer survivors were included, and these numbers were reduced for individual biomarker analyses. We found that exercise significantly reduced fasting insulin levels [WMD, -3.46 μU/mL; 95% confidence interval (CI), -5.97 to -0.95; = 0.007]. Furthermore, potentially meaningful but statistically nonsignificant changes were observed in insulin resistance (WMD, -0.73; 95% CI, -0.54 to 0.13; = 0.23), adiponectin (WMD, 1.17 μg/mL; 95% CI, -0.87 to 3.20; = 0.26), and C-reactive protein (WMD, -1.10 mg/L; 95% CI, -2.39 to 0.20; = 0.10). Subgroup analyses showed that fasting insulin levels were significantly more impacted in studies in which intervention participants experienced a weight reduction (WMD, -7.10 μU/mL; 95% CI, -10.31 to -3.90; < 0.001). Exercise reduces fasting insulin levels in breast cancer survivors. This may be due to exercise-induced reductions in body weight. Practitioners and clinicians may better help breast cancer prognosis be improved through exercise, anticipating physiological effects on cancer. .

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It is essential for healthcare providers to apply various programs, including those targeted at accepting illness, improving autonomy and independently managing disease, to adolescents with congenital heart disease.

BackgroundIt has been recognized that alternate day calorie restriction (ADCR) or exercise has positive effects on cardio-metabolic risk factors. It is unclear whether the combined effect of ADCR and exercise (aerobic + resistance training) influences risk. We investigated effects of an 8-week ADCR and exercise program (aerobic + resistance training) on cardio-metabolic risk factors in overweight and obese adults.MethodsThis study randomized 45 overweight or obese but healthy adults (F = 26, M = 19; aged about 32 to 40 years) into 4 groups: ADCR (n = 13), exercise (n = 10), exercise plus ADCR (n = 12), and control (n = 10) for 8 weeks. Body composition, blood lipids profile, and insulin resistance were measured. The intention to treat (ITT) method was used to analyze all participants that were randomized.ResultsA total of 35 participants completed the trial (78%). Body weight, body mass index, waist circumference, fat mass and percent body fat were reduced in the exercise plus ADCR group (− 3.3 ± 2.4 kg, p < 0.01; − 1.3 ± 1.0 kg/m2, p < 0.01; − 4.1 ± 3.9 cm, p < 0.01; − 2.7 ± 2.0 kg, p < 0.01; − 2. 5 ± 2.2%, p < 0.01). Insulin, glucose, homeostasis model assessment insulin resistance and triglyceride (− 2.9 ± 4.1 μIU/ml, p < 0.05; − 10.9 ± 16.9 mg/dl, p < 0.05; − 0.9 ± 1.3, p < 0.05; − 43.8 ± 41.9 mg/dl, p < 0.01) decreased in the exercise plus ADCR group only.ConclusionsADCR and exercise both proved to be beneficial, but the combined intervention was most effective at inducing beneficial changes in body weight, body composition, glucose, insulin, insulin resistance and triglyceride in overweight and obese adults.Trial registrationClinicalTrials.gov: NCT03652532, Registered August 28, 2018, ‘retrospectively registered’.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6009-1) contains supplementary material, which is available to authorized users.

Physical activity may decrease the risk of dementia; however, conflicting findings exist. The purpose of the current meta-analysis was to investigate the relationship between physical activity and dementia risk based on physical activity type, amount, and intensity, and to propose an effective minimal physical activity amount for older adults. Forty-four studies were selected for the meta-analysis. Participation in high (a total of >2 hours of activity over the course of three sessions per week) and moderate (a total of >1 hour of activity over the course of two sessions per week) amounts of physical activity showed decreased dementia risks compared to physical inactivity. Vigorous exercise, regular exercise, leisure time physical activities, and gardening showed a positive effect toward lowering dementia risk, but walking was not associated with dementia risk. Physically inactive individuals had a higher dementia risk than those who participated in physical activity. Participation in physical activities produces a favorable effect toward lowering dementia risk. Participating in regular physical activity of >1 hour over the course of two sessions per week and avoiding physical inactivity are recommended for lowering dementia risk. [ Journal of Gerontological Nursing, 44( 10), 22–29.]